Surgical Treatment of Articular Cartilage Defects in the Knee: Are We Winning?

Memon, Adeel R.; Quinlan, John

doi:10.1155/2012/528423

Cited by 18 publications

(16 citation statements)

References 51 publications

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“…Articular cartilage is devoid of blood vessels and nerves with low presence of chondrocytes with minimum mitotic activity, therefore this particular tissue has little or no potential for healing compared with other tissues. The inability of articular cartilage to regenerate was first reported by Hunter in 1743 ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Leukocyte and Platelet Rich Plasma (L-PRP) Versus Leukocyte and Platelet Rich Fibrin (L-PRF) For Articular Cartilage Repair of the Knee: A Comparative Evaluation in an Animal Model

Kazemi¹,

Fakhrjou²

2015

Iran Red Crescent Med J

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Background:Articular cartilage injuries of the knee are among the most debilitating injuries leading to osteoarthritis due to limited regenerative capability of cartilaginous tissue. The use of platelet concentrates containing necessary growth factors for cartilage healing has recently emerged as a new treatment method.Objectives:The efficacy of two types of different platelet concentrates were compared in the treatment of acute articular cartilage injuries of the knee in an animal model.Materials and Methods:Eighteen adult Iranian mixed breed male dogs were used to conduct this experimental study. Full thickness articular cartilage defects (diameter 6 mm, depth 5 mm) were created in the weight bearing area of femoral condyles of both hind limbs in all dogs (n = 72). Twelve dogs were randomly selected to receive treatment and their right and left hind limb defects were treated by L-PRP and L-PRF implantation respectively, while no treatment was undertaken in six other dogs as controls. The animals were euthanized at 4, 16 and 24 weeks following surgery and the resultant repair tissue was investigated macroscopically and microscopically. At each sampling time, 4 treated dogs and 2 control dogs were euthanized, therefore 8 defects per group were evaluated.Results:Mean macroscopic scores of the treated defects were higher than the controls at all sampling times with significant differences (P < 0.05) observed between L-PRF treated and control defects (10.13 vs. 8.37) and L-PRP treated and control defects (10 vs. 8.5) at 4 and 16 weeks, respectively. A similar trend in mean total microscopic scores was observed with a significant difference (P < 0.05) between L-PRP treated and control defects at 4 (9.87 vs. 7.62) and 16 (13.38 vs. 11) weeks. No significant difference was observed between the platelet concentrate treated defects in either mean macroscopic scores or mean total microscopic scores.Conclusions:Both L-PRP and L-PRF could be used to effectively promote the healing of articular cartilage defects of the knee.

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Section: Introductionmentioning

confidence: 99%

Leukocyte and Platelet Rich Plasma (L-PRP) Versus Leukocyte and Platelet Rich Fibrin (L-PRF) For Articular Cartilage Repair of the Knee: A Comparative Evaluation in an Animal Model

Kazemi¹,

Fakhrjou²

2015

Iran Red Crescent Med J

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“…With a limited endogenous ability for self-repair, damaged cartilage as a result of disease or trauma oftentimes leads to premature arthritis. Although current clinical methods are insufficient for long-term treatment [6], tissue engineering strategies provide promising alternatives for cartilage repair. To date, many research groups have adapted a wide variety of natural or synthetic polymers for the fabrication of scaffolds for cartilage tissue engineering.…”

Section: Introductionmentioning

confidence: 99%

Osteochondral tissue regeneration using a bilayered composite hydrogel with modulating dual growth factor release kinetics in a rabbit model

Kim

Lam

et al. 2013

Journal of Controlled Release

124

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Biodegradable oligo(poly(ethylene glycol) fumarate) (OPF) composite hydrogels have been investigated for the delivery of growth factors (GFs) with the aid of gelatin microparticles (GMPs) and stem cell populations for osteochondral tissue regeneration. In this study, a bilayered OPF composite hydrogel that mimics the distinctive hierarchical structure of native osteochondral tissue was utilized to investigate the effect of transforming growth factor-β3 (TGF-β3) with varying release kinetics and/or insulin-like growth factor-1 (IGF-1) on osteochondral tissue regeneration in a rabbit full-thickness osteochondral defect model. The four groups investigated included (i) a blank control (no GFs), (ii) GMP-loaded IGF-1 alone, (iii) GMP-loaded IGF-1 and gel-loaded TGF-β3, and (iv) GMP-loaded IGF-1 and GMP-loaded TGF-β3 in OPF composite hydrogels. The results of an in vitro release study demonstrated that TGF-β3 release kinetics could be modulated by the GF incorporation method. At 12 weeks post-implantation, the quality of tissue repair in both chondral and subchondral layers was analyzed based on quantitative histological scoring. All groups incorporating GFs resulted in a significant improvement in cartilage morphology compared to the control. Single delivery of IGF-1 showed higher scores in subchondral bone morphology as well as chondrocyte and glycosaminoglycan amount in adjacent cartilage tissue when compared to a dual delivery of IGF-1 and TGF-β3, independent of the TGF-β3 release kinetics. The results suggest that although the dual delivery of TGF-β3 and IGF-1 may not synergistically enhance the quality of engineered tissue, the delivery of IGF-1 alone from bilayered composite hydrogels positively affects osteochondral tissue repair and holds promise for osteochondral tissue engineering applications.

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“…In vitro studies have demonstrated that the use of bilayer collagen membranes presents an adequate environment for cell attachment and chon drogenic differentiation (Gigante et al, 2007). However, there are no clinical findings that clearly prove the superiority of MACI over existing techniques (Memon and Quinlan, 2012): Indeed, no differences were found in the arthroscopic appearances, histological observations, and rates of tissue hypertrophy between collagen I/III-based ACI-C and bilayer collagen-based MACI grafts used in the treatment of symptomatic cartilage defect cases (Bartlett et al, 2005). MACI is nonetheless an attractive treatment method, as it provides a means of arthroscopic implantation that reduces invasive ness and operation times.…”

Section: Current Treatment Methods For Cartilage Injuriesmentioning

confidence: 99%